Indicaties voor antibiotische profylaxe bij patiënten met een gewrichtsprothese

- Under certain circumstances, patients with a prosthetic joint and a focal infection elsewhere in the body may be at risk of developing bacterial infection of the prosthesis.

- Patients and physicians should actively prevent infections that can spread systemically.

- Routine antibiotic prophylaxis is not recommended for all patients with a prosthetic joint and suspected bacteraemia.

- Antibiotic prophylaxis is warranted in three groups of patients with a prosthetic joint who must undergo an invasive procedure that could cause bacteraemia: patients with a predisposing immunocompromising systemic condition or those receiving immunosuppressive therapy, patients with a dermatological infection, and patients with an obvious focal infection, e.g. urosepsis. If the patient is already receiving antibiotics for the infection, additional prophylaxis is usually unnecessary.

- For patients undergoing dental procedures who require antibiotic prophylaxis, amoxicillin-clavulanic acid or clindamycin are preferred.

Ned Tijdschr Geneeskd. 2008;152:2282-6